A 'free' NHS that penalises pensioners

Christine Doyle reports on a Scrooge-like clawback

RICHARD STOYLES, 72, had just survived severe pneumonia. "It was touch and go for a while," he says. Back home after treatment in an NHS hospital, he was looking forward to a quiet convalescence.

Then a financial bombshell arrived from his local social security office. Because he had been in hospital for longer than six weeks, he had to pay back £17 a week for two weeks from his state retirement pension - about 20 per cent of his total income.

Had he stayed longer in hospital, the "payback" would have risen to a maximum of 60 per cent of his retirement pension. For the average pensioner, this would mean a deduction of £56.28 a week.

At any one time, 30,000 old people are in a similar situation which can mean serious financial hardship. Mr Stoyles, a retired research and development chemist and later a gardener, says: "It was a severe blow. My pension at the time was about £85 and my wife's was £30, so £17 a week was a lot to lose."

The demand for what many pensioners see as a Scrooge-like charge usually comes as a complete shock. Mr Stoyles, a dignified man, says: "I had a vague idea that you are supposed to send back your pension book after six weeks in hospital, but I was too ill to think about that. And I had no idea it meant money would be taken away."

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There was, he says, no chance to appeal and he felt too debilitated to argue, so, as demanded, he returned his pension book. There was no mention, needless to say, of how he was expected to manage without his pension while the bureaucratic wheel turned.

Most people on state pensions are, like Mr Stoyles, largely unaware of the "clawback". Although the debate about charges to see a GP or "hotel bills" for being in hospital is gathering pace, Tony Blair resolutely defends the NHS principle of "free at the point of use". Age Concern, which is campaigning to have the deduction abolished, says: "Older people are being penalised for being ill."

The logic behind the scheme, which dates back to the introduction of the NHS and can also affect other benefits, is that the state should not pay twice for food and other living costs. Age Concern argues that the "rule is outdated, unjust and hits people when they are most vulnerable".

Mr Stoyles says: "I thought my pension was my money, paid for with my contributions and to which I was as entitled as anyone who pays into a private scheme." As he points out, nobody of working age pays any direct charge for being in an NHS hospital. Nor is anyone on a private or company pension expected to pay.

Gwyn Prosser, Labour MP for Dover and Deal, who is supporting the charity, has the backing of more than 150 MPs of all parties to change the system. It is extremely complex and costly to administer and provides the Government with little more than £60 million a year - before administrative costs. Even short stays are added together when the reduction in pension or other benefits is being calculated.

Mr Prosser has tabled an Early Day Motion, and he expects the Speaker to make time for a full debate. Other organisations supporting the campaign include the British Medical Association and the Royal College of Nursing.

Previous pleas have fallen on ministerial deaf ears, and the charity's present initiative is the first major campaign on the issue. Gordon Lishman, Age Concern's director general, says: "It is outrageous that many older people who have paid a lifetime of contributions find themselves in financial difficulties."

Health officials may think that patients are getting good personal care but Mr Stoyles disagrees. "The food can be rotten," he says. "Every day, my wife brought in food that was easy to eat, but cost more than at home. Travel added to the expense. And she took my laundry home."

Even the cost of phone calls, a lifeline to those with distant relatives, eats into meagre incomes. Some patients keep on home carers, to help them while they are in hospital and to be there when they get home. Household bills still have to be paid.

Age Concern knew of a woman with a severe blood disorder who spent her dying weeks worrying about the reduction in her pension and her inability to pay for her grandchildren to visit.

So it is scarcely surprising that many older patients wonder if "free at the point of use" no longer applies once they are pensioners. Mr Prosser concludes: "Nye Bevan would be turning in his grave."